Great Bentley Running Club New member registration - 2019-20
Title (i.e Mr, Mrs, Miss, Dr, etc) *
Your answer
Forename *
Your answer
Surname *
Your answer
Gender *
Date of birth *
MM
/
DD
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YYYY
Age at 1st April 2019 *
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Email *
Your answer
Address *
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Phone number *
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Membership type *
Required
I consent to these details being held by the Club Secretary and Membership secretary and being disclosed to England Athletics for the purposes of membership and added to a closed Google group used for emailing all club members. *
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Membership of another Athletic/ Running Club
If yes - please state the name of any previous club and your status with them (ie first or second claim)
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Contact in an emergency - Name, Relationship to you and contact number *
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